Abstract
We aim to summarize the available literature on patients treated with robotic RYGB and compare the clinical outcomes of patients treated with robotic RYGB with those treated with the standard laparoscopic RYGB. A systematic literature search of PubMed and Scopus databases was conducted in accordance with the PRISMA guidelines. Fourteen comparative and 11 non-comparative studies were included in this study, reporting data on 5145 patients. This study points to comparable clinical outcomes between robotic and laparoscopic RYGB. Robotic-assisted RYGB was associated with significantly less frequent anastomotic stricture events, reoperations, and a decreased length of hospital stay compared with the standard laparoscopic procedures; however, these findings should be interpreted with caution given the low number and poor quality of the studies currently available in the literature.
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Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4(4):353–7.
Carlin AM, Zeni TM, English WJ, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg. 2013;257(5):791–7.
Agaba EA, Shamseddeen H, Gentles CV, et al. Laparoscopic vs open gastric bypass in the management of morbid obesity: a 7-year retrospective study of 1,364 patients from a single center. Obes Surg. 2008;18(11):1359–63.
Banka G, Woodard G, Hernandez-Boussard T, et al. Laparoscopic vs open gastric bypass surgery: differences in patient demographics, safety, and outcomes. Arch Surg. 2012;147(6):550–6.
Keslar PJ, Buck JL, Selby DM. From the archives of the AFIP. Infantile hemangioendothelioma of the liver revisited. Radiographics. 1993;13(3):657–70.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–34.
Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. 2011 Available from www.cochrane-handbook.org
Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses. Dept of Epidemiology and Community Medicine, University of Ottawa: Ottawa, Canada. Available at: (http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed 30.6.2014.
Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.
Ayloo SM, Addeo P, Buchs NC, et al. Robot-assisted versus laparoscopic Roux-en-Y gastric bypass: is there a difference in outcomes? World J Surg. 2011;35(3):637–42.
Benizri EI, Renaud M, Reibel N, et al. Perioperative outcomes after totally robotic gastric bypass: a prospective nonrandomized controlled study. Am J Surg. 2013;206(2):145–51.
Curet MJ, Curet M, Solomon H, et al. Comparison of hospital charges between robotic, laparoscopic stapled, and laparoscopic handsewn Roux-en-Y gastric bypass. J Robot Surg. 2009;3(2):75–8.
Hagen ME, Pugin F, Chassot G, et al. Reducing cost of surgery by avoiding complications: the model of robotic Roux-en-Y gastric bypass. Obes Surg. 2012;22(1):52–61.
Hubens G, Balliu L, Ruppert M, et al. Roux-en-Y gastric bypass procedure performed with the da Vinci robot system: is it worth it? Surg Endosc. 2008;22(7):1690–6.
Mohr CJ, Nadzam GS, Curet MJ. Totally robotic Roux-en-Y gastric bypass. Arch Surg. 2005;140(8):779–86.
Myers SR, McGuirl J, Wang J. Robot-assisted versus laparoscopic gastric bypass: comparison of short-term outcomes. Obes Surg. 2013;23(4):467–73.
Park CW, Lam EC, Walsh TM, et al. Robotic-assisted Roux-en-Y gastric bypass performed in a community hospital setting: the future of bariatric surgery? Surg Endosc. 2011;25(10):3312–21.
Sanchez BR, Mohr CJ, Morton JM, et al. Comparison of totally robotic laparoscopic Roux-en-Y gastric bypass and traditional laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005;1(6):549–54.
Scozzari G, Rebecchi F, Millo P, et al. Robot-assisted gastrojejunal anastomosis does not improve the results of the laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2011;25(2):597–603.
Snyder BE, Wilson T, Leong BY, et al. Robotic-assisted Roux-en-Y Gastric bypass: minimizing morbidity and mortality. Obes Surg. 2010;20(3):265–70.
Snyder BE, Wilson T, Scarborough T, et al. Lowering gastrointestinal leak rates: a comparative analysis of robotic and laparoscopic gastric bypass. J Robot Surg. 2008;2(3):159–63.
Wood MH, Kroll JJ, Garretson B. A comparison of outcomes between the traditional laparoscopic and totally robotic Roux-en-Y gastric bypass procedures. J Robot Surg. 2013;8(1):29–34.
Artuso D, Wayne M, Grossi R. Use of robotics during laparoscopic gastric bypass for morbid obesity. JSLS. 2006;9:266–8.
Ayloo S, Fernandes E, Choudhury N. Learning curve and robot set-up/operative times in singly docked totally robotic Roux-en-Y gastric bypass. Surg Endosc. 2014;28(5):1629–33.
Ayloo SM, Addeo P, Shah G, et al. Robot-assisted hybrid laparoscopic Roux-en-Y gastric bypass: surgical technique and early outcomes. J Laparoendosc Adv Surg Tech A. 2010;20(10):847–50.
Buchs NC, Pugin F, Bucher P, et al. Learning curve for robot-assisted Roux-en-Y gastric bypass. Surg Endosc. 2012;26(4):1116–21.
Deng JY, Lourie DJ. 100 robotic-assisted laparoscopic gastric bypasses at a community hospital. Am Surg. 2008;74(10):1022–5.
Diamantis T, Alexandrou A, Gouzis K, et al. Early experience with totally robotic Roux-en-Y gastric bypass for morbid obesity. J Laparoendosc Adv Surg Tech A. 2010;20(10):797–801.
Mohr CJ, Nadzam GS, Alami RS, et al. Totally robotic laparoscopic Roux-en-Y Gastric bypass: results from 75 patients. Obes Surg. 2006;16(6):690–6.
Moser F, Horgan S. Robotically assisted bariatric surgery. Am J Surg. 2004;188(4A Suppl):38S–44S.
Parini U, Fabozzi M, Contul RB, et al. Laparoscopic gastric bypass performed with the Da Vinci Intuitive Robotic System: preliminary experience. Surg Endosc. 2006;20(12):1851–7.
Ramos AC, Domene CE, Volpe P, et al. Early outcomes of the first Brazilian experience in totally robotic bariatric surgery. ABCD Arq Bras Cir Dig. 2013;26(Suplemento 1):2–7.
Tieu K, Allison N, Snyder B, et al. Robotic-assisted Roux-en-Y gastric bypass: update from 2 high-volume centers. Surg Obes Relat Dis. 2013;9(2):284–8.
Yu SC, Clapp BL, Lee MJ, et al. Robotic assistance provides excellent outcomes during the learning curve for laparoscopic Roux-en-Y gastric bypass: results from 100 robotic-assisted gastric bypasses. Am J Surg. 2006;192(6):746–9.
Markar SR, Karthikesalingam AP, Venkat-Ramen V, et al. Robotic vs. laparoscopic Roux-en-Y gastric bypass in morbidly obese patients: systematic review and pooled analysis. Int J Med Rob. 2011;7(4):393–400.
Maeso S, Reza M, Mayol JA, et al. Efficacy of the Da Vinci surgical system in abdominal surgery compared with that of laparoscopy: a systematic review and meta-analysis. Ann Surg. 2010;252(2):254–62.
Morino M, Pellegrino L, Giaccone C, et al. Randomized clinical trial of robot-assisted versus laparoscopic Nissen fundoplication. Br J Surg. 2006;93(5):553–8.
Acknowledgments
We would like to thank Drs. Catherine Mohr, Mario Morino, Stephan Myers, Chan W. Park, Gitana Scozzari, and Michael Wayne, for either providing us with requested additional data or clarifying data for us.
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Konstantinos P. Economopoulos and Vasileios Theocharidis contributed equally to this work.
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Economopoulos, K.P., Theocharidis, V., McKenzie, T.J. et al. Robotic vs. Laparoscopic Roux-En-Y Gastric Bypass: a Systematic Review and Meta-Analysis. OBES SURG 25, 2180–2189 (2015). https://doi.org/10.1007/s11695-015-1870-9
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DOI: https://doi.org/10.1007/s11695-015-1870-9